Tactical Medical Coordination System

Monday, 01 December 2008

A patient’s location, physical condition, and treatment history can be tracked.

The term “tactical medical coordination system” (TacMedCS) denotes any of several prototype electronic systems for tracking patients in a scenario that may involve multiple instances of treatment by different medical personnel in different locations. The TacMedCS was conceived as a means of facilitating coordination of care of military personnel injured in combat and/or facilitating coordination of care of victims of large-scale disasters. The most advanced prototype has already been demonstrated to be effective in operations at a Navy fleet hospital.

The TacMedCS is, somewhat more specifically, a system of electronic data-communication and computing hardware and software for disseminating, among all cognizant medical personnel, the information on the physical condition, medical treatment, and location of every patient for whom the military or humanitarian organization in question is responsible. TacMedCS is required to function in such adverse settings as battlefields and field hospitals, where it may be subjected to climatological extremes, dirt, sand, and water. It is required to be flexible enough to support both combat and humanitarian missions and to function in locations where there are no mature electronic communication systems or where electronic communication systems have been disabled.

Even when medical care is provided in an established hospital or similar fixed facility, locating patients and providing detailed information on the treatment of each patient can be difficult. The difficulty is magnified when a patient is wounded in a combat zone and may need to be evacuated in several stages, receiving different levels of care at each stage. Medical personnel at each stage must guess what previous medical treatment has been performed, guess whom they might ask for information, or even guess the patient’s name. Prior to the conception of the TacMedCS, none of the readily available data-storage devices (computer disks, thumb drives, cassette voice recorders, and paper records) has been consistently successful in communicating patient information to the next level of care.

To limit costs, the development of the TacMedCS has involved the use of commercial-off-the-shelf equipment as much as possible. The developers of the TacMedCS decided to base the system on passive radio-frequency identification (RFID) tags, for which there already exists a substantial technological infrastructure and which offer substantial advantages over such other tracking systems as those based on optically scanned bar codes. RFID offers inexpensive, durable, reliable, easy-to-use, safe means of tracking patients. RFID tags can include computer chips that can store patient data and can be contained within plastic bracelets like those commonly used to identify patients in hospitals. Moreover, an RFID tag can be made to protect some of its stored data (e.g., a serial number) against future overwriting and to accommodate updating of such other data as those indicating the last known location of the patient and identifying medical treatments and personnel who administered them.

Information can be written onto, or read from, an RFID wrist tag by use of a commercially available hand-held dedicated RFID reader/writer unit or a commercially available RFID card inserted into a laptop or desktop computer. In more-advanced prototype versions of the TacMedCS, the reader/ writer, communication node, and data-entry/ data-display units are subunits integrated into a single hand-held unit. Information read from a tag can be uploaded to a local medical database from such a unit or from an RFID-enabled computer. From there, the data can be sent elsewhere by use of the Internet, a cellular telephone network, or other established data-communication network. In the absence of direct local access to the network, the data can be sent via satellite radiotelephone to a central server computer connected to the network. After the data have been received by a central server computer, the data can be retrieved by use of a computer that is connected to the network and equipped with commercially available software that generates a graphical user interface designed specifically for use in querying and displaying medical data.

If the data recently recorded in a tag cannot be transmitted because of lack or failure of communication equipment, the data can be stored in the tag. In some versions of the TacMedCS, the data in the tag can be encrypted. The quantity of data that can be stored depends partly on the level of encryption; in one version in which an advanced encryption standard is used, the tag can hold information for three successive treatment sessions.

This work was done by Diane Williams of the Naval Health Research Center. NRL-0031